Last updated September 2011. Planned review date: September 2013

Explaining premature birth - risks and causes

Lifestyle and premature birth

You can reduce the risk of your baby being born prematurely by choosing not to smoke, drink alcohol or use recreational drugs.

Try not to worry if you enjoyed a booze-fuelled night out before you knew you were pregnant, the likelihood is that it will not affect your baby. You can make a conscious decision to avoid alcohol though once you know you're pregnant. The same goes for smoking and the other activities below that may harm your unborn baby. Read more here on changing your lifestyle to reduce the risk of premature birth.

Risk factors

Using alcohol or recreational drugs

Alcohol can harm your developing baby. You should not drink at all in the first semester and ideally not at all until after the birth.

If you use cocaine or heroin while pregnant, you will be twice as likely to have your baby prematurely, and your baby will be at increased risk of infant mortality. You may also be susceptible to other complications, such as infections related to injecting.

Smoking

Smoking during pregnancy increases the risk of premature birth up to two-fold and is associated with waters breaking early.

What you can do to reduce your risk is to give up now. Find out more reasons why it's so important to quit.

Age

If you become pregnant in your teens or over the age of 35, you will have a higher risk of premature birth.

Weight

You are at higher risk of having your baby early if you have poor nutrition or are underweight - particularly if your body mass index (BMI) was below 18.5 before you became pregnant.

If you are obese (with a BMI of more than 30), you are also at increased risk of medical intervention leading to premature birth.

If you find you are already pregnant and overweight, you must not diet during pregnancy, but you can improve your lifestyle. Find out more here about managing your weight in pregnancy.

Income and employment

It is widely recognised that people who have more opportunity in life have better health. There is evidence of inequalities across many areas of health - and that includes the statistics for premature delivery. Poverty and social disadvantage are linked with higher rates of premature birth, as is demanding physical work.

Antenatal care

Many women who have premature babies have less frequent contact with antenatal services, either because they are unavailable or the mother does not attend appointments. This means that women who are at risk of premature delivery are more likely to have their babies prematurely because the healthcare team is unable to check for warning signs.

What you can do to avoid this is to try and attend all of your antenatal appointments.

Psychological state

Physical and verbal abuse appear to make women four times more likely to go into premature labour, and women who are victims of domestic violence are more likely to have a premature baby.

Women experiencing stress or depression are up to twice as likely to have their baby prematurely, though this may be because they are more likely to use drugs or alcohol to cope. Severe depression puts women at risk of having smaller babies born prematurely.

If you're feeling very stressed, don't struggle on alone: it's important to get help. You could confide in your partner or a friend, or seek advice from your GP. Find out where to get help for depression.

Ethnicity

In most developed countries, women from non-white ethnic groups are more likely to have premature birth than other women.

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In this section


Explaining premature birth:

Your premature baby:

You can also read about


Sources

NICE (2008) Antenatal care: routine care for the healthy pregnant woman, CG062, National Institute for Health and Clinical Excellence

NHS Choices (accessed Sept 2011) Health A-Z, Pre-conception - risks, http://www.nhs.uk/Conditions/Preconception/Pages/Risks.aspx

Turner K, Hutchinson S, Vickerman P et al (2011) The impact of needle and syringe provision and opiate substitution therapy on the incidence of Hepatitis C virus in injecting drug users: pooling of UK evidence, Addiction, May 10.1111/j.1360-0443.2011.03515

BMJ Best Practice (2011) Premature newborn care, diagnosis, history and examination, drug use, http://bestpractice.bmj.com/best-practice/monograph/671/diagnosis/history-and-examination.html

Hadley C, Main DM, Gabbe SG et al (1990) Risk Factors for Preterm Premature Rupture of the Fetal Membranes, American Journal or Perinatology, 7(4): 374-379
DOI: 10.1055/s-2007-999527

Henderson D, Macdonald S (2004) Mayes Midwifery (13th edition), London, Balliere Tindall

Raatikainen K, Heiskanen N, Heinonen S (2007) Under-attending free antenatal care is associated with adverse pregnancy outcomes, BMC Public Health, Vol 27, p268

Rodrigues T, Rocha L, Barros H (2008) Physical abuse during pregnancy and preterm delivery, American Journal  of Obstetrics and Gynecology, Feb;198(2):171.e1-6.

BMJ Clinical Evidence (2011) Premature labour, basics, aetiology, http://bestpractice.bmj.com/best-practice/monograph/1002/basics/aetiology.html

James D, Steer PJ, Wiener C et al (2011) High risk pregnancy, management options, fourth edition, Elsevier Saunders


Comments

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Feedback on health information

'You get pregnant and somehow you feel that it's your right for it to be OK. I was 30, I was a bit overweight - that was in the back of my mind - but generally I was in good health, so why should anything go wrong?'

DEBBIE

'Afterwards, we really wanted some answers, and it was very unsatisfying. But it's one of those things we've had to put behind us. It's one of those black holes: ifs and buts and whys. At some stage they might come back, but for now our baby is home and safe, and it's negative to think about all that.'

EMILY